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Working Together to Prevent Patient Harm and Reduce CostsFHA Hospital Engagement Network UpdateMarch 2015
Florida Hospitals’ Continuing Quality Improvement JourneyHistorically, Florida hospitals worked on quality improvement initiatives independently – until seven years ago, when hospitals joined together under the leadership of the Florida Hospital Association (FHA) to improve care, save lives and lower costs.
Florida hospitals united on several FHA quality programs, working collaboratively to achieve a common goal – to make care safer. In 2012, FHA, in partnership with the American Hospital Association’s Health Research & Educational Trust, launched the largest hospital quality improvement project in Florida: the Centers for Medicare and Medicaid Services (CMS) Partnership for Patients (PfP) Hospital Engagement Network (HEN). The initiative set a bold goal of reducing patient harm by 40 percent and preventable readmissions by 20 percent in just three years.
Through this effort, our hospitals focused on providing patient and family centered care, helping patients heal more quickly, return home sooner and get back to work faster, all while keeping costs down for patients and businesses.
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Our hospitals focused on providing patient and family centered care, helping patients heal more quickly, return home sooner and get back to work faster, all while keeping costs down for patients and businesses.
FHA Hospital Engagement NetworkThrough the FHA HEN, Florida hospitals continued to build on our foundation of collaboration. Hospitals focused on 11 areas with the highest incidences of preventable harm.
With 77 hospitals working through the FHA HEN, along with 62 more Florida hospitals participating in other HENs, this initiative became the state’s largest collective effort ever to improve care. Never before has there been so much focus and collaborative work done on eliminating the same types of patient harm.
Participating hospitals committed significant resources to the project, including tracking and reporting data for each focus area, forming quality teams and participating in ongoing calls and meetings to expand their knowledge and skills. This initiative required engagement at all levels of the hospital, from the executive team to frontline caregivers.
HEN Focus Areas• Adverse Drug Events
• Catheter Associated Urinary Tract Infections
• Central Line Associated Blood Stream Infections
• Early Elective Deliveries
• Falls
• Obstetric harm
• Pressure Ulcers
• Readmissions
• Surgical Site Infections
• Ventilator Associated Events
• Venous Thromboembolism
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Our Efforts Made A Difference Due to our hospitals’ commitment, tremendous strides were made, benefiting patients, families and communities across Florida.
Preliminary analysis of the project results found over 27,500 cases of harm were prevented, the overall harm rate was reduced by 54 percent and an estimated $170 million in health care costs were avoided.
Highlighted achievements include:
»» 4,649 adverse drug events were prevented. Partnerships with hospital pharmacists had a significant impact on increasing medication safety.
»» Reduced non-medically necessary deliveries before 39 weeks by 97 percent. 2,711 early deliveries were prevented. All 41 participating maternity hospitals established “hard stop” policies to eliminate delivery before 39 weeks without a medical reason and improve health outcomes for mothers and babies.
»» Lowered the rates of catheter associated urinary tract infections by 18 percent. 1,081 infections were prevented. Hospitals participated in monthly conference calls and were able to consult with hospital infection experts to implement steps to prevent these infections.
»» Saved $4.2 million in costs associated with blood stream infections. FHA quality staff conducted site visits and one-on-one coaching to support hospitals.
»» Avoided 15,000 hospital readmissions, saving $138 million through the “No Place Like Home Campaign”, which highlighted interventions designed to improve care transitions when a patient leaves the hospital.
»» Prevented nearly 1,000 falls with injury. Held multiple educational calls with the leading national expert on falls prevention.
»» Achieved a 61 percent reduction in pressure ulcers. Connected hospitals to national “boot camps” on preventing pressure ulcers and encouraged adoption of the evidence based practices.
In addition to the 11 targets, FHA HEN hospitals also worked on reducing dangerous infections such as Clostridium difficile (C. diff), Methicillin-resistant Staphylococcus Aureus (MRSA), sepsis and several other complications.
Over 27,500 cases of harm were prevented, the overall harm rate was reduced by 54 percent and an estimated $170 million in health care costs were avoided.
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How We Did ItWe know that by working together on quality and patient safety, we can accelerate our learning and drive lasting improvements.
Through the FHA HEN, Florida hospitals had access to state and national resources and were able to work with others across the country to share best practices and improve at even faster rates. Ongoing training and resources were provided, including regular conference calls/webinars, statewide meetings, toolkits, on-demand learning, coaching and data sharing. As the project evolved, hospitals implemented a tool to measure their overall harm score. The Harm Across the Board assessment examined actual, and potential, risk for patient harm and measured the hospitals’ progress toward the goal of zero harm. All resources and support were provided at no cost to hospitals participating in the FHA HEN.
Key to the effort was the focus on a culture of safety and increasing patient and family engagement. Patient and family participation as active members of their health care team is an essential component of making care safer.
Partnering with other organizations such as Florida Medical Quality Assurance, Inc., Florida’s Quality Improvement Organization, and the Florida Perinatal Quality Collaborative were also critical to accomplishing our goals. FHA HEN benefited from the knowledge and expertise provided by others focused on the same quality work.
Onward!Florida hospitals have made notable progress to improve patient safety. We have created a solid platform, built on the power of collaboration, to achieve further milestones. The connections made will help us build on our improvements in the years ahead.
Work goes on to eliminate patient harm and reduce readmissions. Hospitals, providers and caregivers continue to partner and learn from one another.
Future phases of the national Partnership for Patients campaign are under consideration by CMS, with HEN 2.0 launching later in 2015. Looking ahead, we will remain focused on eliminating all types of patient harm, with the goal of making Florida hospitals the safest in the country.
FHA HEN participating hospitals:
All Children’s Hospital Johns Hopkins Medicine
Arnold Palmer Hospital for Children
Baptist Medical Center Beaches
Baptist Medical Center Jacksonville
Baptist Medical Center Nassau
Baptist Medical Center South
Bascom Palmer Eye Inst/Anne Bates Leach Eye Hosp
BayCare Alliant Hospital
Bayfront Health St. Petersburg
Bert Fish Medical Center
Brooks Rehabilitation Hospital
Broward Health Coral Springs
Broward Health Imperial Point
Broward Health Medical Center
Broward Health North
Cape Coral Hospital
Citrus Memorial Health System
Coral Gables Hospital
Delray Medical Center, Inc.
DeSoto Memorial Hospital
Doctors’ Memorial Hospital, Inc.
Dr. P. Phillips Hospital
Eastside Psychiatric Hospital
Fishermen’s Community Hospital
Flagler Hospital, Inc.
Florida Medical Center - A Campus of North Shore
Good Samaritan Medical Center
Gulf Coast Medical Center
H. Lee Moffitt Cancer Center and Research Institute
Health Central Hospital
Health First Cape Canaveral Hospital
Health First Holmes Regional Medical Center
Health First Palm Bay Hospital
Health First Viera Hospital
HealthPark Medical Center
Hendry Regional Medical Center
Hialeah Hospital
Indian River Medical Center
Jackson Hospital
Jackson Memorial Hospital
Jackson North Medical Center
Jackson South Community Hospital
Jupiter Medical Center
Lakeside Medical Center
Lee Memorial Hospital
LifeStream Behavioral Center, Inc.
Mease Countryside Hospital
Participating HospitalsThe 77 Florida hospitals participating in the FHA HEN came from every region of the state, from the Florida Keys to the Florida Panhandle. They represent rural, community, urban and even specialty hospitals, some of which were standalone, while others were part of a hospital system. This diverse array of viewpoints led to creative new ideas and opportunities to reduce harm.
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Our hospitals focused on providing patient and family centered care, helping patients heal more quickly, return home sooner and get back to work faster, all while keeping costs down for patients and businesses.
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Mease Dunedin Hospital
Morton Plant Hospital
Morton Plant North Bay Hospital
NCH Downtown Naples Hospital
NCH North Naples Hospital
North Okaloosa Medical Center
North Shore Medical Center
Northwest Florida Community Hospital
Orlando Regional Medical Center
Palm Beach Gardens Medical Center
Palmetto General Hospital
Regional General Hospital Williston
Sarasota Memorial Health Care System
South Florida Baptist Hospital
South Lake Hospital
South Seminole Hospital
St. Anthony’s Hospital
St. Joseph’s Hospital, Inc.
St. Joseph’s Hospital-North
St. Joseph’s Women’s Hospital
St. Mary’s Medical Center
Tampa General Hospital
UF Health Shands Psychiatric Hospital
UF Health Shands Rehab Hospital
University of Miami Hospital
University of Miami Hospital and Clinics
West Boca Medical Center, Inc.
Westchester General Hospital
Winnie Palmer Hospital for Women & Babies
Winter Haven Hospital, Inc.
We will continue to focus on eliminating all types of patient harm, with the goal of making Florida hospitals the safest in the country.
For more information about the FHA HEN contact:Kim Streit Vice President of Health Care Research & Information Services [email protected]
Sally Forsberg Director of Quality and Patient Safety [email protected]
